Search results for: nurses practices

Authors: Reda Moussa Massoud Embark

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Tourism and hospitality graduate development is key to the future state of the tourism and hospitality industry. Meanwhile, Information and Communication Technology is increasingly becoming the engine for improving productivity and business opportunities in the travel and hospitality industry. Given the challenges and fierce global competition that have arisen in today's hospitality industry, it was important to shed light on strategic management. In addition, five-star hotels play a key role in supporting the tourism industry and investments in Egypt. Therefore, this study aims to examine the extent to which strategic management practices are implemented in five-star hotels in Egypt and to examine the differences between resort and inner-city hotels in terms of the implementation of strategic management processes. The influence of different hotel types on the implementation of the strategic management process is examined. A simple random sampling technique is used to select a sample of the target population, including hotels in the cities of Sharm el-Sheikh, Cairo and Hurghada. The data collection tool used in this study is an interviewer-administered questionnaire. Finally, combining the study results with the literature review allowed to present a set of recommendations to be addressed to hoteliers in the area of strategic management practices. Education and training in tourism and hospitality must take these changes into account in order to improve the ability of future managers to use a variety of tools and strategies to make their organizations more efficient and competitive. Therefore, this study aims to examine the types and effectiveness of training courses offered by tourism and hospitality departments in Egypt and to assess the importance of these training courses from the perspective of the graduate. The survey is aimed at graduates who have completed three different majors in the past decade: tourism and hospitality. Findings discussed the nature, level and effectiveness of the training provided at these faculties and the extent to which the training programs were valued by graduates working in different fields, and finally recommended specific practices to improve learning effectiveness increase and increase perceived employee benefits in the tourism and hospitality industry.

Keywords: marketing channels, crisis, hotel, international, tour, operators, online travel agencies, e-tourism, hotel websites, tourism, web-tourism, strategic-management, strategic tools, five-star hotels, resorts, downtown hotels, Egyptian Markets.

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Authors: Gurbinder Kaur

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It is notable that due to advanced technology and trends adopted by service providers to kill competition, the concept of ‘consumer interest’ is no longer limited to a domestic extent, but it is extended to extraterritorial limits. Therefore, the focus of this research work is to examine the regulation of consumer protection at the international level and its correspondence with the domestic laws of various countries. Consumer interest is tendered by various trade practices like pricing policies, financing practices, and quality of goods and services. Nowadays, the term ‘consumer’ is not limited merely to the person who consumes the goods and avails services as an end user. In fact, every individual is a consumer, regardless of occupation, age, gender, community or religious affiliation. The term ‘consumer’ would therefore include not only the consumer of the final product but also the consumer of raw material and intermediate products. Despite apparent variation among domestic laws of various countries, the veneer is almost the same, with the emphasis on purchasing, consuming or using goods or services. Thus, the definition of ‘consumer’ is widened to those of old laws while keeping in consideration the present scenario of the victimization of consumers and their exploitation or unfair advantages taken by the trading world. Moreover, Lack of awareness, illiteracy and consumer buying behaviour, ignorant behaviour or reluctance to take the initiative to check the problem or tolerance against trade tricks and frauds are some of the reasons behind the victimization of consumers. All governments must protect consumers from fraud, unfair trade tricks and practices from within and outside of their respective countries. This paper not only evaluates the modern concept of the consumer but also analyzes the consumer behaviour, rights and liabilities of consumers along with their protection through various corresponding laws of the governments of other nations. These laws empower competition regulatory authorities to enter into a memorandum or arrangement with the prior approval of their domestic Governments, with any relevant agency of any foreign country. For the said purpose, an overview has been made about comparative and critical analyses of the working of International Organizations in the form of treaties, covenants, conventions and reports submitted by international economists, experts and jurists internationally, which are crucial parts of today’s business jurisprudence (specifically relating to the consumer interest) of developed and developing countries. After analyzing them, the researcher has made an earnest attempt to encapsulate the chronological background of consumer jurisprudence along with current situations in various countries.

Keywords: consumer interest, consumer education, trade, consumer protection

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Authors: Kenneth N. Ohei, Roelien Brink

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For decades, teaching and learning processes have centered on the traditional approach (Web 1.0) that promoted teacher-directed pedagogical practices. Currently, there is a realization that the traditional approach is not adequate to effectively address and improve all student-learning outcomes. The subsequent incorporation of social software, Information, and Communication Technology (ICT) tools in universities may serve as complementary to support educational goals, offering students the affordability and opportunity to educational choices and learning platforms. Consequently, educators’ inability to incorporate these instructional ICT tools in their teaching and learning practices remains a challenge. This will signify that educators still lack the ICT skills required to administer lectures and bridging learning gaps. This study probes a methodological concept with the aim of developing a framework towards the adoption of social software in HES to help facilitate business processes and can build social presence among students. A mixed method will be appropriate to develop a comprehensive framework needed in Higher Educational System (HES). After research have been conducted, the adoption of social software will be based on the developed comprehensive framework which is supposed to impact positively on education and approach of delivery, improves learning experience, engagement and finally, increases educational opportunities and easy access to educational contents.

Keywords: blended and integrated learning, learning experience and engagement, higher educational system, HES, information and communication technology, ICT, social presence, Web 1.0, Web 2.0, Web 3.0

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Authors: Cheryl Marie Cordeiro

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Although fisheries and aquaculture studies might seem marginal to international business (IB) studies in general, fisheries and aquaculture IB (FAIB) management is currently facing increasing pressure to meet global demand and consumption for fish in the next coming decades. In part address to this challenge, the purpose of this systematic review of literature (SLR) study is to investigate the use of the term ‘market access’ in its context of use in the generic literature and business sector discourse, in comparison to the more specific literature and discourse in fisheries, aquaculture and seafood. This SLR aims to uncover the knowledge/interest gaps between the academic subject discourses and business sector practices. Corpus driven in methodology and using a triangulation method of three different text analysis software including AntConc, VOSviewer and Web of Science (WoS) analytics, the SLR results indicate a gap in conceptual knowledge and business practices in how ‘market access’ is conceived and used in the context of the pharmaceutical healthcare industry and FAIB research and practice. While it is acknowledged that the product orientation of different business sectors might differ, this SLR study works with the assumption that both business sectors are global in orientation. These business sectors are complex in their operations from product to market. This SLR suggests a conceptual model in understanding the challenges, the potential barriers as well as avenues for solutions to developing market access for FAIB.

Keywords: market access, fisheries and aquaculture, international business, systematic literature review

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Authors: Annie Ramanbhai Mecwan

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Cleaning validation in a pharmaceutical manufacturing facility is documented evidence that a cleaning process has effectively removed contaminants, residues from previous drug products and cleaning agents below a pre-defined threshold from the reusable tools and parts of equipment. In shared manufacturing facilities more than one drug product is prepared. After cleaning of reusable tools and parts of equipment after one drug product manufacturing, there are chances that some residues of drug substance from previously manufactured drug products may be retained on the equipment and can carried forward to the next drug product and thus cause cross-contamination. Health-based limits through the derivation of a safe threshold value called permitted daily exposure (PDE) for the residues of drug substances should be employed to identify the risks posed at these manufacturing facilities. The PDE represents a substance-specific dose that is unlikely to cause an adverse effect if an individual is exposed to or below this dose every day for a lifetime. There are different practices to calculate PDE. Data for all APIs in the public domain are considered to calculate PDE value though, company to company may vary the final PDE value based on different toxicologist’s perspective or their subjective evaluation. Hence, Regulatory agencies should take responsibility for publishing PDE values for all APIs as it is done for elemental PDEs. This will harmonize the PDE values all over the world and prevent the unnecessary load on manufacturers for cleaning validation

Keywords: active pharmaceutical ingredient, good manufacturing practice, NOAEL, no observed adverse effect level, permitted daily exposure

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Authors: Mohammed Mustafa, Fatima Abusin, Mariam Abufatema

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Objective: This audit aims to evaluate the practices and outcomes of operative vaginal deliveries (OPVD) at Mayo University Hospital, focusing on identifying trends, complications, and adherence to clinical guidelines. Methods: A retrospective review was conducted on all cases of operative vaginal deliveries at Mayo University Hospital over one year. Data was collected from patient records, including demographics, OPVD indications, types of instruments used (forceps or vacuum), maternal and neonatal outcomes, and any associated complications. Statistical analyses were performed to assess the rates of successful and unsuccessful OPVDs and identify factors influencing outcomes. Results: The study included 159 [out of 174 total OPVD in 1 year] cases of operative vaginal deliveries. The indications predominantly consisted of the prolonged second stage of labor, fetal distress and suspicious CTG. The success rate of OVD was [97.5%]; maternal perineal tears [10 cases], hemorrhage[43 cases] and neonatal outcomes needed for SCBU admission[12 cases] were also assessed. Conclusion: This audit provides insights into the current practices and outcomes of operative vaginal deliveries at Mayo University Hospital. The findings underline the importance of adherence to clinical guidelines and highlight areas for potential improvement in practice

Keywords: OPVD operative vaginal delivery, GTG green top guidelines, PPH postpartum hemorrhage, SCBU special care baby unit

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Authors: Md. Abdul Karim, Syed Imran Ahmed, Pandora T. Hardtman

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Informed consent is one of the basic human and ethical rights for childbearing women. It plays a central role in promoting informed decision making between patients and service providers during the labor process. It gives mothers rights to accept or reject any examination and/or procedure, increases the respect and dignity of the mother during pregnancy, delivery and postpartum care. To assess the practices of this right during normal vaginal delivery and immediate postpartum care in tertiary level hospital setting in Bangladesh, a quantitative study with cross-sectional design was conducted in Dhaka Medical College & Hospital (DMCH) and Sir Salimullah Medical College & Mitford Hospital (SSMCH) in Dhaka in November 2015. A prevalence-based sample size of 190 was calculated where prevalence, confidence interval and level of significance were at 9.7%, 98% and 5% respectively. The respondents were the mothers who gave normal vaginal childbirth within past 24 hours and received postpartum care there. They were selected through systematic random sampling technique and their face-to-face interview of 190 mothers was done using a structured questionnaire. Data were entered into the spreadsheet (MS Excel 2013 version) and descriptive analysis of findings was done. The result shows the complete absence of informed consent practices and mostly absence of consented care such as right to information, respect for choices of preferences for examination and/or procedure of childbearing women. Although 95% of the mothers were informed that they were being proceeded with normal vaginal delivery, their choice of preference was absent during the process. Only consent (not informed consent) was taken from 50%-72% mothers for examination (except breast examination ‘0%’) and 8%-83% for any procedures during postpartum care. Only one-ninth (11%) of the mothers could ask service providers regarding the services they received. No consent was taken from 3% of the mothers- neither in the labor process nor in postpartum care. This current practice doesn’t comply with the Respectful Maternity Care (RMC) Charter 2011. The issue is not even clarified in the current Standard Clinical Management Protocols of the country. So, improvement of the existing protocol and increased awareness are essential to address this right of child-bearing women and to practice it during normal vaginal delivery and postpartum care.

Keywords: informed consent, normal vaginal delivery, respectful maternity care, tertiary level hospital

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Authors: John Bankier

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Development of academic English occurs not only in communities of practice but also within wider social networks, referred to by Zappa-Hollman and Duff as individual networks of practice. Such networks may exist whether students are developing academic English in English-dominant contexts or in contexts in which English is not a majority language. As yet, little research has examined how newcomers to universities interact with a variety of social ties in such networks to receive academic and emotional support as they develop the academic English necessary to succeed in local and global academia. The one-year ethnographic study described in this presentation followed five Japanese university students enrolled on an academic English program in their home country. We graphically represent participants’ individual networks of practice related to academic English and display the role of interaction in these networks to socialization. Specific examples of academic practices will be linked to specific instances of social interaction. Interaction supportive of the development of academic practices often occurred during unplanned interactions outside the classroom and among small groups of close friends who were connected to each other in more than one way, such as those taking multiple classes together. These interactions occurred in study spaces, in hallways between class periods, at lunchtimes, and online. However, constraints such as differing accommodation arrangements, class scheduling and the hierarchical levelling of English classes by test scores discouraged some participants both from forming strong ties related to English and from interacting with existing ties. The presentation will briefly describe ways in which teachers in all contexts can maximise interaction outside the classroom.

Keywords: academic, english, practice, network

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Authors: Md. Samim Hossain Molla, Md. Mazharul Anwar, Md. Akkas Ali, Mian Sayeed Hassan

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Being detached about 68 years from the mainland, the previous enclaves’ (Chhitmohal) farmers were engaged only in subsistence farming with low agricultural productivity and restricted access to inputs technology. To increase crop productivity for attaining food security by addressing soil status, the experiments were undertaken in 2017 and 2018 in three previous enclaves of Northern Bangladesh i.e. Dasiarchhara of Kurigram district; Dahalakhagrabari of Panchagarh district and Banskata of Lalmonirhat district under On-Farm Research Division, Bangladesh Agricultural Research Institute, Rangpur. The Mustard (var. BARI Sarisha-14)-Boro rice (var. BRRI dhan58)-T. Aman rice (var. BRRI dhan49) cropping pattern using soil test based (STB) fertilizer with cowdung (T1) or recommended fertilizer dose (T2) were tested against existing cropping pattern Fallow-Boro rice (var. BRRI dhan28)-T. Aman rice (var. Swarna) using farmers’ practices fertilizer dose (T3) in six disperse replications at each location maintaining Randomized Complete Block design. Almost all crops yields were relatively higher in T1 followed by T2. Farmers existing pattern with local varieties and imbalance fertilizer (T3) use may be decreased the crop yield. The rice equivalent yield of T1 was 109, 103 and 95% higher than T3 and the gross margin was 164, 153 and 133% higher in T1 than T3 at Dasiarchhara, Dahalakhagrabari and Banskata, respectively. The Benefit Cost Ratio for T1, T2 and T3 were 1.99, 1.78 and 1.28 in Dasiarchhara; 1.93, 1.81 and 1.27 in Dahalakhagrabari and 1.78, 1.71 and 1.25 in Banskata, respectively. There was a remarkable decrease in mineral N, P and K in the topsoil (0–15 cm) of T3 and T2 treatments at Dasiarchhara and Dahalakhagrabari, and a generally less marked decline under the same treatments at Banskata. The same practices (T1) exhibited the greatest nutrients uptake by the test crops. The apparent balance of N, P and K was negative in most cases, where it was less negative in T1 treatment. However, from the experimentation, it is revealed that balanced fertilization (STB) and inclusion of National Agricultural Research Institutes developed improved crops varieties in cropping pattern may increase the crop productivity, farm efficiency and farmer’s income in a remarkable level.

Keywords: cropping pattern, fertilizer management, nutrient balance, previous enclaves

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Authors: Irfan Ahmad, Raza Ghafoor, Hammad Raza Ahmad, Muhammad Asif, Farrakh Nawaz, M. Tahir Siddiqui

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Due to the exploding population of Pakistan the pressure on natural forests is increasing to meet the demands of wood and wood based products. Agroforestry is being practiced throughout the world on scientific basis but unfortunately the farmers of Pakistan are reluctant in its adoption. The presents study was designed to assess the adoption of agroforestry practices in Faisalabad with respect to land holdings of farmers and future suitability by using Geographic information system (GIS). Faisalabad is the third largest city of the country and is famous due to the textile industry. A comprehensive survey from target villages of the Lyallpur town of Faisalabad district was carried out. Out of total 65 villages, 40 were selected for study. From each selected village, one farmer who was actively engaged in farming activities was selected. It was observed that medium sized farmers having 10-20 acre were more in number as compared to small and large farmers. Number of trees was found maximum in large farm lands, ratio of diseased trees was almost similar in all categories with maximum in small farmlands (24.1%). Regarding the future prospects 35% farmer were interested in agroforestry practices 65% were not interested in the promotion of trees due to the non-availability of technical guidance and proper markets. Geographic images of the study site can further help the researchers and policy makers in the promotion of agroforestry.

Keywords: agroforestry trends, adoption, Faisalabad, geographic information system (GIS)

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Authors: M. Dabirinezhad, M. Bayat Pour, A. Dabirinejad

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In 2020, the technology was introduced to solve some of the deficiencies of direct digital radiology. SDDR is an invention that is capable of capturing dental images without human intervention, and it was invented by the authors of this paper. Adjusting the radiology wave dose is a part of the dentists, radiologists, and dental nurses’ tasks during the radiology photography process. In this paper, an improvement will be added to enable SDDR to set the suitable radiology wave dose according to the density and age of the patients automatically. The separate sensors will be included in the sensors’ package to use the ultrasonic wave to detect the density of the teeth and change the wave dose. It facilitates the process of dental photography in terms of time and enhances the accuracy of choosing the correct wave dose for each patient separately. Since the radiology waves are well known to trigger off other diseases such as cancer, choosing the most suitable wave dose can be helpful to decrease the side effect of that for human health. In other words, it decreases the exposure time for the patients. On the other hand, due to saving time, less energy will be consumed, and saving energy can be beneficial to decrease the environmental impact as well.

Keywords: dental direct digital imaging, environmental impacts, SDDR technology, wave dose

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Authors: Mohiuddin Ahsanul Kabir Chowdhury, Nafisa Lira Huq, Afroza Khanom, Rafiqul Islam, Abdullah Nurus Salam Khan, Farhana Karim, Nabila Zaka, Shams El Arifeen, Sk. Masum Billah

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After having astounding achievements in reducing maternal mortality and achieving the target for Millennium Development Goal (MDG) 5, the Government of Bangladesh has set new target to reduce Maternal Mortality Ratio (MMR) to 70 per 100,000 live births aligning with targets of Sustainable Development Goals (SDGs). Aversion of deaths from maternal complication by ensuring quality health care could be an important path to accelerate the rate of reduction of MMR. This formative research was aimed at exploring the provision of quality maternal health services at different level of health facilities. The study was conducted in 1 district hospital (DH) and 4 Upazila health complexes (UHC) of Kurigram district of Bangladesh, utilizing both quantitative and qualitative research methods. We conducted 14 key informant interviews with facility managers and 20 in-depth interviews with health care providers and support staff. Besides, we observed 387 normal deliveries from which we found 17 cases of post partum haemorrhage (PPH) and 2 cases of eclampsia during the data collection period extended from July-September 2016. The quantitative data were analyzed by using descriptive statistics, and the qualitative component underwent thematic analysis with the broad themes of facility readiness for maternal complication management, and management of complications. Inadequacy in human resources has been identified as the most important bottleneck to provide quality care to manage maternal complications. The DH had a particular paucity of human resources in medical officer cadre where about 61% posts were unfilled. On the other hand, in the UHCs the positions mostly empty were obstetricians (75%, paediatricians (75%), staff nurses (65%), and anaesthetists (100%). The workload on the existing staff is increased because of the persistence of vacant posts. Unavailability of anesthetists and consultants does not permit the health care providers (HCP) of lower cadres to perform emergency operative procedures and forces them to refer the patients although referral system is not well organized in rural Bangladesh. Insufficient bed capacity, inadequate training, shortage of emergency medicines etc. are other hindrance factors for facility readiness. Among the 387 observed delivery case, 17 (4.4%) were identified as PPH cases, and only 2 cases were found as eclampsia/pre-eclampsia. The majority of the patients were treated with uterine message (16 out of 17, 94.1%) and injectable Oxytocin (14 out of 17, 82.4%). The providers of DH mentioned that they can manage the PPH because of having provision for diagnostic and blood transfusion services, although not as 24/7 services. Regarding management of eclampsia/pre-eclampsia, HCPs provided Diazepam, MgSO4, and other anti-hypertensives. The UHCs did not have MgSO4 at stock even, and one facility manager admitted that they treat eclampsia with Diazepam only. The nurses of the UHCs were found to be afraid to handle eclampsia cases. The upcoming interventions must ensure refresher training of service providers, continuous availability of essential medicine and equipment needed for complication management, availability of skilled health workforce, availability of functioning blood transfusion unit and pairing of consultants and anaesthetists to reach the newly set targets altogether.

Keywords: Bangladesh, health facilities, maternal complications, quality of care

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Authors: Pankaj Prashar, Bimlesh Kumar, Ankita Sood, Anamika Gautam

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Pharmacovigilance (PV) is a rapidly growing discipline in pharmaceutical industries as an integral part of clinical research and drug development over the past few decades. PV carries a breadth of scope from drug manufacturing to its regulation with safer utilization. The fundamental steps of PV not only includes data collection and verification, coding of drugs with adverse drug reactions, causality assessment and timely reporting to the authorities but also monitoring drug manufacturing, safety issues, product quality and conduction of due diligence. Standardization of adverse event information, collaboration of multiple departments in different companies, preparation of documents in accordance to both governmental as well as non-governmental organizations (FDA, EMA, GVP, ICH) are the advancements in discipline of PV. De-harmonization, lack of predictive drug safety models, improper funding by government, non-reporting, and non-acceptability of ADRs by developing countries and reports directly from patients to the monitoring centres respectively are the major road backs of PV. Mandatory pharmacovigilance reporting, frequent inspections, funding by government, educating and training medical students, pharmacists and nurses in this segment can bring about empowerment in PV. This area needs to be addressed with a sense of urgency for the safe utilization of pharmaceuticals.

Keywords: pharmacovigilance, regulatory, adverse event, drug safety

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Authors: Damien P. Fevre, Peter K. Dearden

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Honeybee population sustainability is a critical concern for environmental stability and human food security. The success of a colony relies heavily on the egg-laying capacity of the queen, as it determines the production of thousands of worker bees who, in turn, perform essential functions in foraging and transforming food to make it digestible for the colony. The main sources of nutrition for honeybees are nectar, providing carbohydrates, and pollen, providing protein. This study delves into the impact of the proportion of these macronutrients on the food consumption patterns of nurse bees responsible for feeding the queen and how it affects the characteristics of the eggs produced. Using nutritional geometry, qRT-PCR, and RNA-seq analysis, this study sheds light on the pivotal role of nutrition in influencing gene expression in nurse bees, honeybee queen egg-laying capacity and embryonic development. Interestingly, while nutrition is crucial, the queen's genotype plays an even more significant role in this complex relationship, highlighting the importance of genotype-by-environment interactions. Understanding the interplay between genotype and nutrition is key to optimizing beekeeping management and strategic queen breeding practices. The findings from this study have significant implications for beekeeping practices, emphasizing the need for an appropriate nutrition to support the social nutrition of Apis mellifera. Implementing these insights can lead to improved colony health, increased productivity, and sustainable honeybee conservation efforts.

Keywords: honeybee, egg-laying, nutrition, transcriptomics

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Authors: Wided Khiari, Adel Karaa

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This study aims to establish a typology of Tunisian listed firms according to their corporate governance characteristics and disclosure quality. The paper uses disclosed scores to examine corporate governance practices of Tunisian listed firms. A content analysis of 46 Tunisian listed firms from 2001 to 2010 has been carried out and a disclosure index developed to determine the level of disclosure of the companies. The disclosure quality is appreciated through the quantity and also through the nature (type) of information disclosed. Applying the decision tree method, the obtained tree diagrams provide ways to know the characteristics of a particular firm regardless of its level of disclosure. Obtained results show that the characteristics of corporate governance to achieve good quality of disclosure are not unique for all firms. These structures are not necessarily all of the recommendations of best practices, but converge towards the best combination. Indeed, in practice, there are companies which have a good quality of disclosure, but are not well-governed. However, we hope that by improving their governance system their level of disclosure may be better. These findings show, in a general way, a convergence towards the standards of corporate governance with a few exceptions related to the specificity of Tunisian listed firms and show the need for the adoption of a code for each context. These findings shed the light on corporate governance features that enhance incentives for good disclosure. It allows identifying, for each firm and in any date, corporate governance determinants of disclosure quality. More specifically, and all being equal, obtained tree makes a rule of decision for the company to know the level of disclosure based on certain characteristics of the governance strategy adopted by the latter.

Keywords: corporate governance, disclosure, decision tree, economics

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Authors: Jin Li, Jing Sun, Xiangkun Cai, Lijuanwang, Yanbin Tang, Junsheng Huo

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In order to improve the malnutrition of infants and young children in poor rural areas of China, Chinese government implement a project on improvement of children's nutrition in poor rural areas. Each infant or young child aged 6 to 23 months in selected poor rural areas of China was provided a package of Yingyangbao (YYB) per day, which is a full fat soy powder mixed with multiple micronutrient powders. A technical direction to implement this project comprehensively in poor rural areas of China will be provided by assessing the nutritional status of infants and feeding practices of caregiver. The nutritional intervention was conducted using Yingyangbao for infants aged 6 to 23 months in six poor counties of Shanxi, Yunnan and Hubei Provinces. The caregiver or parents of infants were educated on feeding knowledge and practice. A total of 1840 infants were assessed before the intervention and 1789 infants one year later. The length, weight, hemoglobin concentration of infants were measured to evaluate nutritional status before and after the intervention respectively. The questionnaires were designed to collect data for the basic demographic information and feeding practices. The average weight of infants aged 6 to 23 months increased from 9.59 ± 1.54kg to 9.73 ± 1.61kg one years later (p<0.01), and the average length from 76.0±6.0 to 77.0±6.1(p<0.01). The weight and length of infants aged 12 to 17 months had most obviously improving effect among the three age groups. Before the intervention, the hemoglobin concentration value of infants was 11.7±1.2g/L, and the anemia prevalence was 32.9%. One year later, the hemoglobin concentration value of the infants was increased to 12.0±1.1g/dL, and the anemia prevalence was decreased to 26.0%. There were both statistically significant (p <0.01). The anemia prevalence of infants aged 18 to 23 months had most obviously improving effect，which decreased from 25.0% to 17.2%(p<0.01). The proportion of infants aged 6 to 8 months who received solid, semi-solid or soft foods in time was increased from 89.4% to 91.6%, while there was no statistically significant. The proportion of 6-23 month-old infants who received minimum dietary diversity increased from 55.6% to 60.3%(p <0.01). The differences of the proportion of infants who received minimum meal frequency was no statistically significant between before and after the intervention. The nutritional intervention using Yingyangbao showed the significant effect for improving infants aged 6 to 23 months anemia status, weight and length. The feeding practices were improved through education in the process of nutritional intervention, while the effect is not significant. It is need for Chinese government to explore new publicity pattern.

Keywords: nutritional intervention, infants, nutritional status, feeding practice

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Authors: Mohamad Musa

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The history of mental health practices and services in the Middle East region has been deeply intertwined with its rich cultural, religious, and societal context. Tracing back to ancient times, mental health approaches were heavily influenced by the traditions of major monotheistic religions, with a strong emphasis on spiritual and traditional healing methods. As psychiatric institutions and Western medicine gradually gained a foothold in the region during the 20th century, a notable shift occurred. However, the integration of Western psychiatric practices faced significant challenges due to cultural barriers and deeply rooted beliefs. Families and communities often turned to traditional healers and religious practices as their initial recourse for mental health concerns, viewing Western interventions with skepticism and hesitation. Historically, mental health services in the Middle East have been overshadowed by a focus on physical health and the biomedical model. Mental illness carried substantial stigma, with individuals and families often reluctant to disclose mental health struggles due to fears of societal ostracization and discrimination. This stigma posed a significant barrier to accessing and accepting formal mental health support. Later in the 20th century, governments in the Middle East began recognizing the need for modernizing mental health services and integrating them into the broader healthcare system. However, this process was hindered by several factors, including limited resources, inadequate training for healthcare professionals, and ongoing conflicts and instability in certain regions, which disrupted the delivery of mental health services. As the 21st century progressed, several Middle Eastern nations, particularly those in the Arabian Gulf region, began implementing national mental health strategies and legislative reforms to address the growing need for comprehensive mental health care. These efforts aimed to destigmatize mental illness, protect the rights of individuals with mental health conditions, and promote public awareness and education. Despite these positive developments, the historical legacy of stigma, cultural barriers, and limited resources continues to pose challenges in the provision of accessible and culturally responsive mental health services across the diverse populations of the Middle East.

Keywords: mental health, history, middle east, literature review

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Authors: Ruth Muturi Wanjiku

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HIV/AIDS in Kenya for unborn and young kids. HIV/AIDS is a significant health concern in Kenya, with an estimated 1.5 million people living with the disease. Unfortunately, many of these individuals are unaware of their HIV status, and the disease continues to spread among the population or unborn kids. HIV/AIDS can be transmitted from an infected mother during pregnancy, childbirth, or breastfeeding. However, with early testing and treatment, the risk of mother-to-child transmission can be significantly reduced. Therefore, it is crucial for pregnant women to get tested and receive appropriate medical care. For young kids, HIV/AIDS education is critical to preventing the spread of the disease. It is essential to teach children about the importance of safe sex practices, avoiding risky behaviors such as sharing needles and getting tested regularly. Additionally, children should be taught about the stigma surrounding HIV/AIDS and encouraged to treat individuals living with the disease with compassion and respect. In conclusion, HIV/AIDS is a significant health concern in Kenya that affects individuals of all ages. For unborn kids, early testing and treatment are critical to reducing the risk of mother-to-child transmission. For young kids, education about HIV/AIDS and safe sex practices is essential to preventing the spread of the disease and reducing stigma. It is essential to promote awareness and encourage individuals to get tested and seek medical care if they believe they may be infected with HIV/AIDS.

Keywords: AIDS, HIV, children, pregnant

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Authors: Chih-I. Tsai, Yu-Chien. Lin

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Through experiences of clinical practices, it is discovered that locations on the body at a level of four fingerbreadth above and below the joints are the points at which muscles connect to tendons, and since the muscles and tendons possess opposite characteristics, muscles are full of blood but lack qi, while tendons are full of qi but lack blood, these points on our body become easily blocked. It is proposed that through doing acupuncture or creating localized pressure to the areas four fingerbreadths above and below our joints, with an elastic bandage, we could help the energy, also known as qi, to flow smoothly in our body and further improve our health. Based on the Four Fingers Theory, we understand that human height is 22 four fingerbreadths. In addition, qi and blood travel through 24 meridians, 50 times each day, and they flow through 6 cun with every human breath. We can also understand the average number of human heartbeats is 75 times per minute. And the function of qi-blood circulation system in Traditional Chinese Medicine is the same as the blood circulation in Western Medical Science. Informed by Four Fingers Theory, this study further examined its applications in acupuncture practices. The research question is how Four Fingers Theory proves what has been mentioned in Nei Jing that there are 66 acupoints under a human’s elbow and knee. In responding to the research question, there are 66 acupoints under a human’s elbow and knee. Four Fingers Theory facilitated the creation of the acupuncture naming and teaching system. It is expected to serve as an approachable and effective way to deliver knowledge of acupuncture to the public worldwide.

Keywords: four fingers theory, meridians circulation, 66 acupoints under human elbow and knee, acupuncture

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Authors: Tracey Estriplet-Adams

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This paper focuses on the influence of maternal-fetal bonding by examining attachment theory, psycho-social-cultural influences/adaptations, and maternal well-being. A systematic review methodology was used to synthesize research results to summarize current evidence that can contribute to evidence-based practices. It explores the relationship between attachment styles, prenatal attachment, and perceptions of maternal-infant bonding/attachment six weeks postpartum. It also examines the protective factors of maternal-fetal attachment development. The research explores Bowlby's attachment theory and its relevance to maternal-fetal bonding with a Black Feminist Theory lens. Additionally, it discusses the impact of perceived stress, social support, and ecological models on maternal-fetal attachment. The relationship between maternal well-being, maternal-fetal attachment, and early postpartum bonding is reviewed. Moreover, the paper specifically addresses black mothers and maternal-fetal bonding, exploring the intersectionality of race, ethnicity, class, geographic location, cultural identities, and immigration status. It considers the role of familial and partner support, as well as the relationship between maternal attachment style and maternal-fetal bonding, within the framework of attachment theory and black feminist theory. Therefore, it is imperative to center Black women's voices in research, policy, and healthcare practices. Black women are experts in their own experiences and advocate for their autonomy in decision-making regarding maternal-fetal health. By amplifying their voices, we can ensure that interventions are grounded in their lived experiences.

Keywords: maternal-fetal bonding, infant well-being, maternal-infant attachment, black mothers

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Authors: Francis Kwesi Bondinuba, Seidu Abdullah, Nelly Bondinuba

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Purpose: The study proposes a theoretical framework for integrating sustainable project management in the construction sector, addressing the need for sustainable development practices. Methodology: The study adopts a theoretical approach by reviewing existing literature on sustainable development and project management in the construction industry. It analyses various concepts, theories, and frameworks to develop a comprehensive theoretical framework for integrating sustainable project management. Findings: The study emphasizes the importance of incorporating sustainable development practices into construction project management, focusing on collaboration, stakeholder engagement, and continuous improvement to achieve environmental conservation, social responsibility, and economic viability. Conclusion: Sustainable Project Management (SPM) in Ghana's construction industry is challenging due to lack of awareness, regulatory frameworks, financial constraints, and skill shortages, despite its benefits in promoting social inclusivity, job creation, and environmental resilience. Recommendation: The construction industry in Ghana should adopt a comprehensive approach involving local communities, government bodies, and environmental organizations. It should utilize green materials and technologies and effectively manage waste. Originality: This study presents a theoretical framework for sustainable project management in construction. It emphasizes collaboration and stakeholder engagement for long-term sustainable outcomes and considers environmental, social, and economic aspects.

Keywords: construction industry, theoretical framework, integration, project management, sustainable development

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Authors: U. Ugochukwu, J. Lee, P. Conley

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According to a recent survey by the UT Southwestern Workplace Safety Committee, the three most common on-the-job injuries reported by workers at the medical center are musculoskeletal injuries, slip-and-fall injuries and repetitive motion injuries. Last year alone, of the 650 documented workplace injuries and accidents, 45% were seen in employees in their first-two years of employment. UT Southwestern New Employee On-Boarding program was created and modeled to follows OSHA’s model that consist of: determining if training is needed, identifying training needs, identifying goals and objectives, developing learning activities, conducting the training, evaluating program effectiveness, and improving the program. The hospital’s management best practices were recreated to limit and control workplace injuries and accidents. Regular trainings and workshops on workplace safety and compliance were initiated for new employees. Various computer workstations were evaluated and recommendations were made to reduce musculoskeletal disorders. Post exposure protocols and workers protection programs were remodeled for infectious agents and chemicals used in the hospital, and medical surveillance programs were updated, for every emerging threat, to ensure they are in compliance with the US policy, regulatory and standard setting organizations. If ignorance of specific job hazards and of proper work practices is to blame for this higher injury rate, then training will help to provide a solution. Use of this program in training activities is just one of many ways UT Southwestern complied with the OSHA standards that relate to training while enhancing the safety and health of their employees.

Keywords: ergonomics, hazard, on-boarding, surveillance, workplace

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Authors: James Alberto Ortega Morales, Nelson Andrés Martínez Marín

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The bulding industry is one of the most important sectors all around the world in terms of contribution to index like GDP and labor. On the other hand, it is a major contributor to Greenhouse Gases (GHG) and waste generation contributing to global warming. In this sense, it is necessary to establish sustainable practices both from the strategic point of view to the operations point of view as well in all business and industries. Business models don’t scape to this reality attending it´s mediator role between strategy and operations. Business models can turn from the traditional practices searching economic benefits to sustainable bussines models that generate both economic value and value for society and the environment. Recent advances in the analysis of sustainable business models find different classifications that allow finding potential triple bottom line (economic, social and environmental) solutions applicable in every business sector. Into the metioned Advances have been identified, 11 groups and 45 patterns of sustainable business models have been identified; such patterns can be found either in the business models as a whole or found concurrently in their components. This article presents the analysis of a case study, seeking to identify the components and elements that are part of it, using the ECO CANVAS conceptual model. The case study allows showing the concurrent existence of different patterns of business models for sustainability empirically, serving as an example and inspiration for other Latin American companies interested in integrating sustainability into their new and existing business models.

Keywords: sustainable business models, business sustainability, business model patterns, case study, construction industry

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Authors: Anucha Taiwong, Nirobol Kanogsunthornrat

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This predictive research aimed to investigate the symptom clusters that influence the quality of life among patients with chronic kidney disease, as indicated in the Theory of Unpleasant Symptoms. The purposive sample consisted of 150 patients with stage 3-4 chronic kidney disease who received care at an outpatient chronic kidney disease clinic of a tertiary hospital in Roi-Et province. Data were collected from January to March 2016 by using a patient general information form, unpleasant symptom form, and quality of life (SF-36) and were analyzed by using descriptive statistics, factor analysis, and multiple regression analysis. Findings revealed six core symptom clusters including symptom cluster of the mental and emotional conditions, peripheral nerves abnormality, fatigue, gastro-intestinal tract, pain and, waste congestion. Significant predictors for quality of life were the two symptom clusters of pain (Beta = -.220; p < .05) and the mental and emotional conditions (Beta=-.204; p<.05) which had predictive value of 19.10% (R2=.191, p<.05). This study indicated that the symptom cluster of pain and the mental and emotional conditions would worsen the patients’ quality of life. Nurses should be attentive in managing the two symptom clusters to facilitate the quality of life among patients with chronic kidney disease.

Keywords: chronic kidney disease, symptom clusters, predictors of quality of life, pre-dialysis

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Authors: Shuyi Xie

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As the vital city in south China since the ancient time, Guangzhou has been losing its leading role among the rising neighboring cities, especially, Hong Kong and Shenzhen, since the late 1980s, with the overloaded infrastructure and deteriorating urban environment in its old inner city. Fortunately, with the new expansion of its administrative area in 2000, the local municipality considered it as a great opportunity to solve a series of alarming urban problems. Thus, for the first time, strategic planning was introduced to China for providing more convincing and scientific basis towards better urban future. Differed from traditional Chinese planning practices, which rigidly and dogmatically focused on future blueprints, the strategic planning of Guangzhou proceeded from analyzing practical challenges and opportunities towards establishing reasonable developing objectives and proposing corresponding strategies. Moreover, it was pioneering that the municipality invited five planning institutions for proposals, among which, the paper focuses on the one proposed by China Academy of Urban Planning & Design from its theoretical basis to problems’ defining and analyzing the process, as well as planning results. Since it was closer to the following municipal decisions and had a more far-reaching influence for other Chinese cities' following practices. In particular, it demonstrated an innovative exploration on the role played by urban developing rate on deciding urban growth patterns (‘Spillover-reverberation’ or ‘Leapfrog’). That ultimately established an unprecedented paradigm on deciding an appropriate urban spatial structure in future, including its specific location, function and scale. Besides the proposal itself, this article highlights the role of interactions, among actors, as well as proposals, subsequent discussions, summaries and municipal decisions, especially the establishment of the rolling dynamic evaluation system for periodical reviews on implementation situations, as the first attempt in China. Undoubtedly, strategic planning of Guangzhou has brought out considerable benefits, especially opening the strategic mind for plentiful Chinese cities in the following years through establishing a flexible and dynamic planning mechanism highlighted the interactions among multiple actors with innovative and effective tools, methodologies and perspectives on regional, objective-approach and comparative analysis. However, compared with some developed countries, the strategic planning in China just started and has been greatly relied on empirical studies rather than scientific analysis. Moreover, it still faced a bit of controversy, for instance, the certain gap among institutional proposals, final municipal decisions and implemented results, due to the lacking legal constraint. Also, how to improve the public involvement in China with an absolute up-down administrative system is another urgent task. In future, despite of irresistible and irretrievable weakness, some experiences and lessons from previous international practices, with the combination of specific Chinese situations and domestic practices, would enable to promote the further advance on strategic planning in China.

Keywords: evaluation system, global perspective, Guangzhou, interactions, strategic planning, urban growth patterns

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Authors: M. Bortolini, E. Ferrari, F. G. Galizia, C. Mora

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In the last decades, an increasing set of companies adopted lean philosophy to improve their productivity and efficiency promoting the so-called continuous improvement concept, reducing waste of time and cutting off no-value added activities. In parallel, increasing attention rises toward green practice and management through the spread of the green supply chain pattern, to minimise landfilled waste, drained wastewater and pollutant emissions. Starting from a review on contributions deepening lean and green principles applied to supply chain management, the most relevant drivers to measure the performance of industrial processes are pointed out. Specific attention is paid on the role of cost because it is of key importance and it crosses both lean and green principles. This analysis leads to figure out an original reference framework for integrating lean and green principles in designing and managing supply chains. The proposed framework supports the application, to the whole value chain or to parts of it, e.g. distribution network, assembly system, job-shop, storage system etc., of the lean-green integrated perspective. Evidences show that the combination of the lean and green practices lead to great results, higher than the sum of the performances from their separate application. Lean thinking has beneficial effects on green practices and, at the same time, methods allowing environmental savings generate positive effects on time reduction and process quality increase.

Keywords: environmental sustainability, green supply chain, integrated framework, lean thinking, supply chain management

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Authors: Pratima Thapa

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Background: It is very critical to understand that awareness of family planning and proper utilization of contraceptives is an important indicator for reducing maternal and neonatal mortality and morbidity. It also plays an important role in promoting reproductive health of the women in an underdeveloped country like ours. Objective: To assess knowledge, attitude and practices of contraception among married women of reproductive age group in selected wards of Dharan Sub-Metropolitan City. Materials and methods: A cross-sectional descriptive study was conducted among 209 married women of reproductive age. Simple random sampling was used to select the wards, population proportionate sampling for selecting the sample numbers from each wards and purposive sampling for selecting each sample. Semi-structured questionnaire was used to collect data. Descriptive and inferential statistics were used to interpret the data considering p-value 0.05. Results: The mean ± SD age of the respondents was 30.01 ± 8.12 years. Majority 92.3% had ever heard of contraception. Popular known method was Inj. Depo (92.7%). Mass media (85.8%) was the major source of information. Mean percentage score of knowledge was 45.23%.less than half (45%) had adequate knowledge. Majority 90.4% had positive attitude. Only 64.6% were using contraceptives currently. Misbeliefs and fear of side effects were the main reason for not using contraceptives. Education, occupation, and total income of the family was associated with knowledge regarding contraceptives. Results for Binary Logistic Regression showed significant correlates of attitude with distance to the nearest health facility (OR=7.97, p<0.01), education (OR=0.24, p<0.05) and age group (0.03, p<0.01). Regarding practice, likelihood of being current user of contraceptives increased significantly by being literate (OR=5.97, p<0.01), having nuclear family (OR=4.96, p<0.01), living in less than 30 minute walk distance from nearest health facility (OR=3.34, p<0.05), women’s participation in decision making regarding household and fertility choices (OR=5.23, p<0.01) and husband’s support on using contraceptives (OR=9.05, p<0.01). Significant and positive correlation between knowledge-attitude, knowledge-practice and attitude-practice were observed. Conclusion: Results of the study indicates that there is need to increase awareness programs in order to intensify the knowledge and practices of contraception. The positive correlation indorses that better knowledge can lead to positive attitude and hence good practice. Further, projects aiming to increase better counselling about contraceptives, its side effects and the positive effects that outweighs the negative aspects should be enrolled appropriately.

Keywords: attitude, contraceptives, knowledge, practice

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Authors: Medha Talpade, Salil Talpade

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The intent of this quantitative project was to compare the values and perceptions of students from a predominantly white college (PWI) to those from a historically black college (HBCU) about culturally relevant teaching and learning practices in the academic realm. The reason for interrelating student culture with teaching practices is to enable a pedagogical response to the low retention rates of African American students and first generation Caucasian students in high schools, colleges, and their low rates of social mobility and educational achievement. Culturally relevant pedagogy, according to related research, is deemed rewarding to students, teachers, the local and national community. Critical race theory (CRT) is the main framework used in this project to explain the ubiquity of a culturally relevant pedagogy. The purpose of this quantitative study was to test the critical race theory that relates the presence of the factors associated with culturally relevant teaching strategies with perceived relevance. The culturally relevant teaching strategies were identified based on the recommendations and findings of past research. Participants in this study included approximately 145 students from a HBCU and 55 students from the PWI. A survey consisting of 37 items related to culturally relevant pedagogy was administered. The themes used to construct the items were: Use of culturally-specific examples in class whenever possible; use of culturally-specific presentational models, use of relational reinforcers, and active engagement. All the items had a likert-type response scale. Participants reported their degree of agreement (5-point scale ranging from strongly disagree to strongly agree) and importance (3-point scale ranging from not at all important to very important) with each survey item. A new variable, Relevance was formed based on the multiplicative function of importance and presence of a teaching and learning strategy. A set of six demographic questions were included in the survey. A consent form based on NIH and APA ethical standards was distributed prior to survey administration to the volunteers. Results of a Factor Analyses on the data from the PWI and the HBCU, and a ANOVA indicated significant differences on ‘Relevance’ related to specific themes. Results of this study are expected to inform educational practices and improve teaching and learning outcomes.

Keywords: culturally relevant pedagogy, college students, cross-cultural, applied psychology

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Authors: Ana Pinheiro, Fatima Suleman

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Literature has revealed strong awareness of companies in regard of expatriation, but issues associated with repatriation of employees after an international assignment have been overlooked. Repatriation is one of the most challenging human resource practices that affect how companies benefit from acquired skills and high potential employees; and gain competitive advantage through network developed during expatriation. However, empirical evidence achieved so far suggests that expatriates have been disappointed because companies lack an effective repatriation strategy. Repatriates’ professional and emotional needs are often unrecognized, while repatriation is perceived as a non-issue by companies. The underlying assumption is that the return to parent company, and original country, culture and language does not demand for any particular support. Unfortunately, this basic view has non-negligible consequences on repatriates, especially on expatriate retention and turnover rates after expatriation. The goal of our study is to examine the specific policies and practices adopted by companies to support employees after an international assignment. We assume that expatriation is process which ends with repatriation. The latter is such a crucial issue as the expatriation and require due attention through appropriate design of human resource management policies and tools. For this purpose, we use data from a qualitative research based on interviews to a sample of firms operating in Portugal. We attempt to compare how firms accommodate the concerns with repatriation in their policies and practices. Therefore, the interviews collect data on both expatriation and repatriation process, namely the selection and skills of candidates to expatriation, training, mentoring, communication and pay policies. Portuguese labor market seems to be an interesting case study for mainly two reasons. On the one hand, Portuguese Government is encouraging companies to internationalize in the context of an external market-oriented growth model. On the other hand, expatriation is being perceived as a job opportunity in the context of high unemployment rates of both skilled and non-skilled. This is an ongoing research and the data collected until now indicate that companies follow the pattern described in the literature. The interviewed companies recognize the higher relevance of repatriation process than expatriation, but disregard specific human resource policies. They have perceived that unfavorable labor market conditions discourage mobility across companies. It should be stressed that companies underline that employees enhanced the relevance of stable jobs and attach far less importance to career development and other benefits after expatriation. However, there are still cases of turnover and difficulties of retention. Managers’ report non-negligible cases of turnover associated with lack of effective repatriation programs and non-recognition of good performance. Repatriates seem to having acquired entrepreneurial spirit and skills and often create their own company. These results suggest that even in the context of worsening labor market conditions, there should be greater awareness of the need to retain talents, experienced and highly skills employees. Ultimately, other companies poach invaluable assets, while internationalized companies risk being training providers.

Keywords: expatriates, expatriation, international management, repatriation

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Authors: Mojtaba Zabihi, Stephen Munro, Jonathan Little, Ri Li, Joshua Brinkerhoff, Sina Kheirkhah

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Occupational Safety and Health Administration (OSHA) identified dental workers at the highest risk of contracting COVID-19. This is because aerosol-generating procedures (AGP) during dental practices generate aerosols ( < 5µm) and droplets. These particles travel at varying speeds, in varying directions, and for varying durations. If these particles bear infectious viruses, their spreading causes airborne transmission of the virus in the dental room, exposing dentists, hygienists, dental assistants, and even other dental clinic clients to the infection risk. Computational fluid dynamics (CFD) simulation of two-phase flows based on a discrete phase model (DPM) is carried out to study the spreading of aerosol and droplets in a dental room. The simulation includes momentum, heat, and mass transfers between the particles and the airflow. Two simulations are conducted and compared. One simulation focuses on the effects of room ventilation in winter and summer on the particles' travel. The other simulation focuses on the control of aerosol and droplets' spreading. A suction collector is added near the source of aerosol and droplets, creating a flow sink in order to remove the particles. The effects of the suction flow on the aerosol and droplet travel are studied. The suction flow can remove aerosols and also reduce the spreading of droplets.

Keywords: aerosols, computational fluid dynamics, COVID-19, dental, discrete phase model, droplets, two-phase flow

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